Lichen planus bullous lichen planus perri dermatology. Haematoxylin h is a dark blue or violet histology stain that is positively charged, and binds to negatively charged basophilic substances, such as dna and rna. Bullous lichen planus is a rare variant of lichen planus. Clinical variants of lichen planus wiley online library. Distinct violaceous plaques in conjunction with blisters. With lichen planus, lichen means tree moss and planus refers to flat, and the reason its called that, is that lichen planus is a flattopped skin rash that looks a bit like tree moss. Like other forms of lichen planus, it is characterized by a skin rash shiny, flattopped, firm bumps that are a purple color and vary from pin point size to larger than a centimeter. We report the largest patient series of fblp and describe its clinical characteristics and inheritance pattern.
Lichen planus may affect the skin cutaneous lichen planus, oral cavity oral lichen planus, genitalia penile or vulvar lichen planus, scalp lichen planopilaris, nails, or esophagus. Lichen planus causes, symptoms, diagnosis, treatment. Oral lichen planus is a relatively common chronicinflammatory immunologic reaction in whichepidermal or epithelial basal cell damageproduces mucocutaneous lesions of varioustypesoral lichen planus is a common chronicimmunologic. Squamous cell carcinoma arising in oral lichen planus. Differentiating bullous lichen planus and lichen planus pemphigoides. Lichen planus may occur as an oralconfined bullous eruption. Lichen planus pemphigoides is a rare condition characterized by blisters arising on normal or erythematous skin in a patient with concurrent lichen planus. The documents contained in this web site are presented for information purposes only.
A crossover condition of lp and lupus erythematosus has also been described. Bullous lichen planus is a form of lichen planus in which bullae blisters accompany the lichenoid papules and plaques and i occasionally encounter this version in my the woodlands dermatology and conroe dermatology offices. Lichen planus pemphigoides lpp is a rare crossover syndrome between lichen planus and bullous pemphigoid. Bullous lichen planus of the nails dermatology jama. Lichenoid keratosis is harmless and resolves spontaneously. Bullous lichen planus verma r, vasudevan b, kinra p. Oral lichen planus and oral lichenoid lesions in addition, lichenoid lesions on the mucosal side of the lip, possibly initiated by microbial plaque precipitated on the buccal surfaces of the anterior teeth, have been reported as a. An update on etiology, pathogenesis, clinical presentation, diagnosis and management. Lichen planus lp is an inflammatory papulosquamous disease which may affect the squamous epithelium of the esophagus. They also help to control the symptoms of lichen planus without any side effects. Histopathology of resembles that of lichen planus or lichenoid drug eruption, with some slight differences. It is seen worldwide, mostly in the fifth to sixth decades of life, and is twice as common in women than in men.
Histopathology confirmed the diagnosis of lichen planus and bullous lichen planus. It must be distinguished from bullous lichen planus, in which, as a consequence of severe basal cell hydropic degeneration, blisters arise within lichenoid papules or plaques. It is to be differentiated from lichen planus pemphigoides in which the blisters are more generalized and extensive and the course is. Lichen planus pemphigoides lpp is a rare autoimmune subepithelial blistering disorder with clinical, pathologic, and immunologic features of lichen planus lp and bullous pemphigoid bp. Lichen planus lesions are described using the six ps. Course onset insidious subside in 918 mths chronic hypertrophic. This is evident on histology, with alteration of the dermoepidermal junction and intrabasal bullae as a consequence of extensive inflammation. Lichen planus pemphigoides associated with pregnancy. It is characterized by vesicles or bullae, which usually develop in the context of preexisting lp lesions. The histopathology and direct immunofluorescence were compatible with lpp. A 58yearold woman presented with vulvar erosions, esophagitis, and laryngeal blisters. Lichen planus pemphigoides lpp is a rare condition characterized by tense blisters that arise on lesions of lichen planus lp and on unaffected skin. Lichen planus is a chronic, inflammatory, autoimmune disease that affects the skin, oral mucosa, genital mucosa, scalp, and nails. They are one of the causes of atypical solar lentigo.
Lichen planus pemphigoides lpp is a rare autoimmune subepidermal blistering disease with few cases reported in the literature. Lichen planus is believed to represent an abnormal immune response in which epithelial cells are recognized. Lichen planus lp is a pruritic, chronic inflammatory dermatosis resulting from keratinocyte apoptosis that affects the skin, mucous membranes, genitalia, scalp lichen planopilaris, and nails. Full text pdf abstract lichen planus is a chronic mucocutaneous disease, inflammatory condition, autoimmune nature and. It is characterized by polygonal, flattopped, violaceous papules and plaques with overlying, reticulated, fine white scale wickhams striae, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. This is evident on histology, with alteration of the dermoepidermal junction and. It is one of the most common dermatological conditions involving the oral cavity. We describe a case of lpp in a 12yearold girl with clinical, histological and direct immunofluorescence findings.
Bullous lichen planus of the nails view large download a, before treatment, swelling and violaceous discoloration are apparent on the proximal fingernail folds along with oozing of blood, hemorrhagic crusting of the fingernails, and pus discharging from the lateral nail folds. Squamous cell carcinoma arising in oral lichen planus soussan irani dds, m. Etiology of periodontal diseases part 4 provides a more comprehensive background in periodontal anatomy, physiology, and pathogenesis. This is a relatively rare condition, distinct from bullous lichen planus, and represents an overlap between lichen planus and a group of subepidermal blistering diseases. The presenting symptoms were dysphagia in all six patients and odynophagia two patients. Lichen planus pemphigoides in a child sciencedirect.
Lichen planus is a chronic inflammatory disease that affects skin and mucosa. Sonia gupta 1, manveen kaur jawanda 2 1 department of oral pathology, swami devi dyal hospital and dental college, golpura, barwala, punjab, india 2 laxmibai institute of dental sciences and hospital, patiala, punjab, india. Histology not diagnostic patch parakeratosis spongiosis dermal oedema. Lichen planus symptoms, diagnosis and treatment bmj. Its prevalence in the general population is around 1% to 2%, and there are a large number of cases in females. Edwards, bsc, msc, dds robert kelsch,dmd abstract oral lichen planus olp is a chronic mucosal condition commonly encountered in clinical dental practice. Oral lichen planus olp is the mucosal counterpart of cutaneous lichen planus and it was first described in 1866 as white papular eruptions in the oral cavity. Lichen planus new breakthrough treatment that works. Negative direct immunofluorscence test excluded lichen planus pemphigoides. Lichen planus is an uncommon disorder of unknown cause that most commonly affects middleaged adults. Bullous lichen planus blp is a rare variant of lichen planus, characterized by the development of vesicular and bullous lesions, of skin, nails, hair andor mucosa.
Welling homeopathy treatment for lichen planus is a tried and tested protocol to offer long term relief and permanent cure gradually. Homeopathic medicines for lichen planus act on the body at the level of immunity and restore the deviated function. Lichenoid keratosis is also known as benign lichenoid keratosis, solitary lichen planus, lichen planus like keratosis and involuting lichenoid plaque. Characteristic features include distinctive purplish, flattopped papules discrete or coalescent into plaques on the trunk and flexor surfaces. Blistering mucocutaneous diseases of the oral mucosa a. Assistant professor, department of oral and maxillofacial pathology, hamadan university of medical sciences, hamadan, iran. Lichen planus pemphigoides genetic and rare diseases.
Lichenoid keratosis generally develops in fairskinned patients aged 3080 years. Successful treatment of bullous lichen planus with acitretin monotherapy. There is no standard treatment of bullous lichen planus. Diagnosis by indirect immunofluorescence and treatment with dapsone. Ashy dermatosis ad and lichen planus pigmentosus lpp are both acquired macular pigmentation of uncertain aetiology.
Lichen planus lp is an inflammatory, pruritic disease of the skin and mucous membranes and can be generalized or localized. Familial bullous lichen planus fblp is a rare condition. Despite the controversy surrounding their entities, recent. Definitionlichen planus is a unique common inflammatorydisorder that affects the skin, mucousmembrane, nails and hair. The clinical features of bullous lichen planus include typical lichen planus lesions, accompanied by the formation of bullae on the affected or perilesional skin. It is often misdiagnosed and should be differentiated from other subepidermal bullous. Oral lichen planus olp is a common disorder that affects stratified squamous epithelium virtually exclusively. Lichen planus is a chronic immunemediated inflammatory disease that affects the skin and mucous membranes. Bullous lichen planus is a rare variant which usually presents with blisters occurring over typical lesions of lichen planus. The oral manifestations of lichen planus have been described. Lichen planus pemphigoides lpp is a rare autoimmune subepidermal blistering disease characterized by evolution of vesico bullous skin lesions in patients with active lichen planus. The boy was treated with prednisone 1 mgkg day the dose was gradually tapered and discontinued over the next 1.
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